We evaluated the diagnostic efficacy of pudendal nerve somatosensory evoked potential testing in patients with voiding and/or erectile dysfunction. A total of 55 consecutive patients with voiding and/or erectile dysfunction underwent pudendal nerve somatosensory evoked potential testing during a 2.5-year period. P1 latencies were analyzed in terms of neurological history and neurological physical examination. Abnormal P1 latencies were noted in 46.7 percent of patients with a positive neurological history (p = 0.0060), 52.4 percent with a positive neurological physical examination (p = 0.0580), and 64.7 percent with a positive history and physical examination (p = 0.0007). No patient with a negative neurological history had abnormal P1 latencies. Positive neurological history and physical examination findings in patients with voiding and/or erectile dysfunction correlate significantly with abnormal pudendal nerve somatosensory evoked potential latencies. The subgroup of patients with a positive neurological history and physical examination has the greatest diagnostic yield and is best suited for pudendal nerve somatosensory evoked potential testing.